Prompt resolution of hyperthyroidism and hyperemesis gravidarum after delivery

Severe hyperemesis gravidarum has often been associated with elevated thyroid function. However, it has not been determined whether establishing euthyroidism will result in prompt resolution of nausea and vomiting. We report here a gravida with severe intractable hyperemesis gravidarum requiring four months of parenteral hyperalimentation. This patient consistently demonstrated biochemical evidence of hyperthyroidism with no symptoms and signs other than nausea and vomiting. Although no parenteral form of antithyroid medication is commercially available, methimazole suppositories were developed and administered until thyroid function tests normalized. Despite euthyroidism, nausea and vomiting continued unabated. After delivery, both the elevated thyroid function and the nausea and vomiting resolved within three days.